Accuracy of the Modified Somatic Perception Questionnaire and Pain Disability Index in the Detection of Malingered Pain-Related Disability in Chronic Pain

Abstract

The Modified Somatic Perception Questionnaire (MSPQ) and the Pain Disability Index (PDI) are both popular clinical screening instruments in general orthopedic, rheumatologic, and neurosurgical clinics and are useful for identifying pain patients whose physical symptom presentations and disability may be non-organic. Previous studies found both to accurately detect malingered pain presentations; however, the generalizability of these results is not clear. This study used a criterion groups validation design (retrospective cohort of patients with chronic pain, n = 328) with a simulator group (college students, n = 98) to determine the accuracy of the MSPQ and PDI in detecting Malingered Pain Related Disability. Patients were grouped based on independent psychometric evidence of MPRD. Results showed that MSPQ and PDI scores were not associated with objective medical pathology. However, they accurately differentiated Not-MPRD from MPRD cases. Diagnostic statistics associated with a range of scores are presented for application to individual cases. Data from this study can inform the clinical management of chronic pain patients by screening for psychological overlay and malingering, thus alerting clinicians to the possible presence of psychosocial obstacles to effective treatment and triggering further psychological assessment and/or treatment.

The multiple validities of neuropsychological assessment.

“…The Modified Somatic Perception Questionnaire (MSPQ) and the Pain Disability Index (PDI) were shown by me to discriminate litigants with claims of brain impairment and chronic pain as well as evidence of probable malingering, from group data published on chronic pain samples for these two tests (Larrabee, 2003c). Bianchini et al (2014) replicated and extended my findings with a larger sample, improving the determination of cutting scores, and demonstrating that item endorsement on the PDI and MSPQ was not impacted by degree of actual physical pathology in their pain sample.…”

Multidimensional Malingering Criteria for Neuropsychological Assessment: A 20-Year Update of the Malingered Neuropsychological Dysfunction Criteria

“…Among scales tapping somatic exaggeration, the MMPI-2-RF Fs scale is an SVT created specifically for detecting over-reporting of somatic symptoms and has been used in MND detection ( Table 2 ). There are also a small number of SVTs derived from stand-alone self-report pain inventories such as the Pain Disability Index and stand-alone scales such as the Modified Somatic Perception Questionnaire that have proven useful in the detection of somatic malingering ( Balasanyan et al, 2018 ; Bianchini et al, 2014 ; Crighton, Wygant, Applegate, Umlauf, & Granacher, 2014 ).…”

American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering

“…This finding, however, differed from the results of Proto, Pastorek, Miller, Romesser, Sim, & Linck (2014), who reported reduced neuropsychological performance for TBI cases failing only one PVT, compared to those subjects who passed all PVTs, although this was a military veteran sample that may have had actual or perceived motive to feign. Some investigators have chosen to simply exclude cases with one PVT failure as "indeterminate" ; others have ranked the likelihood of invalid test scores along a continuum (Bianchini et al, 2014;Jones, Ingram, & Ben-Porath, 2012). The advantages and disadvantages of exclusion and inclusion have been discussed and initially tested empirically , with additional research needed on this important topic.…”